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Estimation of Stroke Volume and Stroke Volume Changes by Electrical Impedance Tomography.
da Silva Ramos, Fernando José; Hovnanian, André; Souza, Rogério; Azevedo, Luciano C P; Amato, Marcelo B P; Costa, Eduardo L V.
Afiliación
  • da Silva Ramos FJ; From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
  • Hovnanian A; From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
  • Souza R; Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil.
  • Azevedo LCP; Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil.
  • Amato MBP; From the Department of Intensive Care and Anesthesiology Research Laboratory, Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
  • Costa ELV; Respiratory Intensive Care Unit, University of São Paulo School of Medicine, São Paulo, Brazil.
Anesth Analg ; 126(1): 102-110, 2018 01.
Article en En | MEDLINE | ID: mdl-28742775
BACKGROUND: Electrical impedance tomography (EIT) is a noninvasive imaging method that identifies changes in air and blood volume based on thoracic impedance changes. Recently, there has been growing interest in EIT to measure stroke volume (SV). The objectives of this study are as follows: (1) to evaluate the ability of systolic impedance variations (ΔZsys) to track changes in SV in relation to a baseline condition; (2) to assess the relationship of ΔZsys and SV in experimental subjects; and (3) to identify the influence of body dimensions on the relationship between ΔZsys and SV. METHODS: Twelve Agroceres pigs were instrumented with transpulmonary thermodilution catheter and EIT and were mechanically ventilated in a random order using different settings of tidal volume (VT) and positive end-expiratory pressure (PEEP): VT 10 mL·kg and PEEP 10 cm H2O, VT 10 mL·kg and PEEP 5 cm H2O, VT 6 mL·kg and PEEP 10 cm H2O, and VT 6 mL·kg and PEEP 5 cm H2O. After baseline data collection, subjects were submitted to hemorrhagic shock and successive fluid challenges. RESULTS: A total of 204 paired measurements of SV and ΔZsys were obtained. The 4-quadrant plot showed acceptable trending ability with a concordance rate of 91.2%. Changes in ΔZsys after fluid challenges presented an area under the curve of 0.83 (95% confidence interval, 0.74-0.92) to evaluate SV changes. Conversely, the linear association between ΔZsys and SV was poor, with R from linear mixed model of 0.35. Adding information on body dimensions improved the linear association between ΔZsys and SV up to R from linear mixed model of 0.85. CONCLUSIONS: EIT showed good trending ability and is a promising hemodynamic monitoring tool. Measurements of absolute SV require that body dimensions be taken into account.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Tomografía / Impedancia Eléctrica Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Anesth Analg Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Tomografía / Impedancia Eléctrica Tipo de estudio: Prognostic_studies Límite: Animals Idioma: En Revista: Anesth Analg Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos